Is Reducing Ovarian Volume in Polycystic Ovarian Syndrome Patients after Administration of Metformin Associated with Improving Cardiovascular Risk Factors?

BACKGROUND Women with polycystic ovary syndrome (PCOS) are at increased risk for cardiovascular (CV) and metabolic disorders. There is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy. In randomized trials, the administration of metformin has been shown to be followed by an improvement in insulin sensitivity and decrease in androgen levels in most women. In the present study, we investigate the association between reduced ovarian volume in PCOS patients after administration of metformin with improvement in CV risk factors. MATERIALS AND METHODS This was a randomized clinical trial study. A total of 28 women diagnosed with PCOS who referred to the infertility clinic were selected. Anthropometric characteristics of the patients, mean ovarian volume and plasma levels of fasting blood sugar (FBS), lipid profile, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, testosterone, 17-α-OH progesterone (17OHP), dehydroepiandrosterone sulfate (DHEAS), C-reactive protein (CRP) and homocysteine (Hcy) were evaluated before and after treatment with 500 mg metformin, three times daily for three months. Statistics were calculated with the aid of SPSS 16.0 with student's paired t- and Pearson's correlation coefficient tests. Significance was set at p<0.05. RESULTS There were significant reductions in mean ovarian volume and body mass index (BMI), in addition to CRP, Hcy, testosterone, FBS, HDL and LDL levels. There was a positive correlation between mean ovarian volume and waist-to-hip ratio (WHR).After treatment, there correlation noted with reduction in mean ovarian volume and decreased BMI, in addition to reductions in CRP, LDL, Hcy and testosterone levels. CONCLUSION A positive correlation may exist between reduced mean ovarian volume and improvement in cv risk factors after administration of metformin ( REGISTRATION NUMBER IRCT138903244176N1).